The DOI matches its Crossref record, with a small difference in title or year; 75 of the 76 references it cites were found in a registry or an index.
Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors
Open accessAbstract
Dementia is a growing public health problem for which early detection may be beneficial. Currently, the diagnosis of dementia in primary care is dependent mostly on clinical suspicion on the basis of patient symptoms or caregivers' concerns and is prone to be missed or delayed. We conducted a systematic review of the literature to ascertain the prevalence and contributing factors for missed and delayed dementia diagnoses in primary care. Prevalence of missed and delayed diagnosis was estimated by abstracting quantitative data from studies of diagnostic sensitivity among primary care providers. Possible predictors and contributory factors were determined from the text of quantitative and qualitative studies of patient, caregiver, provider, and system-related barriers. Overall estimates of diagnostic sensitivity varied among studies and seemed to be in part a function of dementia severity, degree of patient impairment, dementia subtype, and frequency of patient-provider contact. Major contributory factors included problems with attitudes and patient-provider communication, educational deficits, and system resource constraints. The true prevalence of missed and delayed diagnoses of dementia is unknown but seems to be high. Until the case for dementia screening becomes more compelling, efforts to promote timely detection should focus on removing barriers to diagnosis.
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“more than 50% of dementia diagnoses are delayed until moderate or advanced stages in primary care,4,5”
From Review of Artificial Intelligence for Clinical Use in Alzheimer's Disease and Related Dementias (2026) · cites this paper as [4]
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“studies have found that diagnosis is delayed until moderate or advanced stages in 50% or more patients with Alzheimer's, 707 , 708”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [708]
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“The lack of confidence of healthcare providers about their knowledge of dementia and healthy ageing has previously been reported. 15,16”
From Awareness of dementia risk reduction among current and future healthcare professionals: A survey study (2021) · cites this paper as [15]
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“Nevertheless, previous studies have shown that general practitioners (GPs) only sporadically provide advice on preventive strategies for dementia, which could be explained by the concerns about their knowledge regarding this topic.15-17”
From Awareness of dementia risk reduction among current and future healthcare professionals: A survey study (2021) · cites this paper as [15]
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Citations
Cites
Crossing the Quality Chasm: A New Health System for the 21st Century
Bloom, B. S. (2002) · JAMA · doi:10.1001/jama.287.5.646-a · Cited by 3,733
Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study
Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B., Burke, J. R., Hurd, M. D., Potter, G. G., Rodgers, W. L., et al. (2007) · Neuroepidemiology · doi:10.1159/000109998 · Cited by 1,932
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Diagnostic error in internal medicine
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Mitchell, A. J. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2008.04.014 · Cited by 1,192
Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims
Gandhi, T. K., Kachalia, A., Thomas, E. J., Puopolo, A. L., Yoon, C., Brennan, T. A., & Studdert, D. M. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-7-200610030-00006 · Cited by 662
Caring for a relative with dementia: family caregiver burden
Papastavrou, E., Kalokerinou, A., Papacostas, S. S., Tsangari, H., & Sourtzi, P. (2007) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2007.04250.x · Cited by 540
Documentation and Evaluation of Cognitive Impairment in Elderly Primary Care Patients
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The Detection of Dementia in the Primary Care Setting
Valcour, V., Masaki, K., Curb, J. D., & Blanchette, P. L. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.19.2964 · Cited by 507
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1 of the 76 references couldn’t be matched to a known paper.
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2016 Alzheimer's disease facts and figures
Alzheimer's Association (2016) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2016.03.001 · Cited by 5,069
Alzheimer disease in the United States (2010–2050) estimated using the 2010 census
Hebert, L. E., Weuve, J., Scherr, P. A., & Evans, D. A. (2013) · Neurology · doi:10.1212/wnl.0b013e31828726f5 · Cited by 2,642
2024 Alzheimer's disease facts and figures
(2024) · Alzheimer's & Dementia · doi:10.1002/alz.13809 · Cited by 2,536
2019 Alzheimer’s disease facts and figures.
Alzheimer's Association (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2019.01.010 · Cited by 2,461
2020 Alzheimer's disease facts and figures
(2020) · Alzheimer's & Dementia · doi:10.1002/alz.12068 · Cited by 2,353
Metadata
- Authors
- Bradford, A., Kunik, M. E., Schulz, P., Williams, S. P., & Singh, H.
- Affiliations
- Baylor College of Medicine (US)
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Bradford, Andrea
- Venue
- Alzheimer Disease & Associated Disorders
- Published
- 2009-10
- Volume
- 23
- Issue
- 4
- Pages
- 306-314
- ISSN
- 0893-0341 (ISSN-L)
- PMC
- PMC2787842
- OpenAlex
- W2055531721
- Cited by
- 969
- References
- 76
- Citations by year
- 2026: 69 · 2025: 101 · 2024: 108 · 2023: 83 · 2022: 116 · 2021: 74 · 2020: 73 · 2019: 65 · 2018: 64 · 2017: 41 · 2016: 39 · 2015: 36 · 2014: 20 · 2013: 25 · 2012: 30
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer Disease & Associated Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (K23CA125585)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- dementia, missed diagnosis, delayed diagnosis, primary care, diagnostic sensitivity, dementia screening, barriers to diagnosis, patient-provider communication, caregiver concerns, dementia severity, dementia subtypes, educational deficit
- MeSH terms
- Dementia, Diagnostic Errors, Humans, Primary Health Care, Risk Factors, Prevalence, Delayed Diagnosis
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